A new otoplasty procedure: combination of perichondrio-adipo-dermal flap, posterior auricular muscle transpositioning and cartilage suturing to decrease the post-operative complication rates

Background

Prominent ear deformity is a common congenital deformity of the external ear affecting 5% of the general population. Although this is a harmless deformity, several publications demonstrate the psychological distress, emotional trauma and behavioural problems that this deformity can inflict on children. As a result of these concerns, corrective prominent ear surgery is now widely performed as a prophylactic surgery.

Methods

Three different prominent ear repair techniques were combined. First, a laterally based perichondrio-adipo-dermal flap was elevated. The posterior auricular muscle was dissected and transected from its insertion. After concha-mastoid suture replacement, the posterior auricular muscle transposition and flap positioning were performed. The helix–mastoid distances and concha-mastoid angles of the patients were measured pre-operatively and at the sixth month of the surgery as the late post-operative assessment. Patients were also evaluated for suture extrusion, granuloma formation, deformity recurrence and postauricular area sensitivity.

Results

Fourteen patients with bilateral prominent ear deformities were treated between January 2016 and January 2017. None of the patients suffered from skin necrosis, suture extrusion, hematoma or wound infection at the early or late post-operative period. No recurrence was noted.

Conclusions

The combination of these three techniques not only decreases post-operative complication rates but also provides a primary otoplasty technique. All three techniques are well-documented and reliable protruding ear correction methods. It was aimed to benefit from specific advantages of each technique while decreasing the complication rates. The primary drawback of our study is the amount of patients in our sample. Complication rates of this technique remain debatable in the 14 cases. The need for further prospective comparative studies about this subject remains.

Level of Evidence: Level IV, therapeutic study.